scholarly journals The Use of Cannabis as a Predictor of Early Onset of Bipolar Disorder and Suicide Attempts

2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
Rafaela Torres Portugal Leite ◽  
Sarah de Oliveira Nogueira ◽  
João Paulo Rodrigues do Nascimento ◽  
Laisa Soares de Lima ◽  
Taís Bastos da Nóbrega ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Early Onset ◽  
Suicide Attempts ◽  
Age At Onset ◽  
Prognostic Significance ◽  
Manic Episode ◽  
Cannabis Use ◽  
Pubmed Database ◽  
Increased Risk ◽  
Bipolar Patients

Introduction. Bipolar disorder (BD) implies risk of suicide. The age at onset (AAO) of BD carries prognostic significance. Substance abuse may precede the onset of BD and cannabis is the most common illicit drug used. The main goal of this study is to review the association of cannabis use as a risk factor for early onset of BD and for suicide attempts.Materials and Methods. PubMed database was searched for articles using key words “bipolar disorder,” “suicide attempts,” “cannabis,” “marijuana,” “early age at onset,” and “early onset.”Results. The following percentages in bipolar patients were found: suicide attempts 3.6–42%; suicide attempts and substance use 5–60%; suicide attempts and cannabis use 15–42%. An early AAO was associated with cannabis misuse. The mean age of the first manic episode in individuals with and without BD and cannabis use disorder (CUD) was 19.5 and 25.1 years, respectively. The first depressive episode was at 18.5 and 24.4 years, respectively. Individuals misusing cannabis showed increased risk of suicide.Discussion. Cannabis use is associated with increased risk of suicide attempts and with early AAO. However, the effect of cannabis at the AAO and suicide attempts is not clear.

Baseline and prodromal characteristics of first- versus multiple-episode mania in a French cohort of bipolar patients

2011 ◽  
Vol 27 (8) ◽  
pp. 557-562 ◽  
Author(s):  
J.-M. Azorin ◽  
A. Kaladjian ◽  
M. Adida ◽  
E. Fakra ◽  
E. Hantouche ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Suicide Attempts ◽  
Correct Diagnosis ◽  
Manic Episode ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Prodromal Phase ◽  
Multiple Episode ◽  
Patients At Risk ◽  
Bipolar Patients

AbstractObjective:To identify some of the main features of bipolar disorder for both first-episode (FE) mania and the preceding prodromal phase, in order to increase earlier recognition.Methods:One thousand and ninety manic patients (FE=81, multiple-episodes [ME]=1009) were assessed for clinical and temperamental characteristics.Results:Compared to ME, FE patients reported more psychotic and less depressive symptoms but were comparable with respect to temperamental measures and comorbid anxiety. The following independent variables were associated with FE mania: a shorter delay before correct diagnosis, greater substance use, being not divorced, greater stressors before current mania, a prior diagnosis of an anxiety disorder, lower levels of depression during index manic episode, and more suicide attempts in the past year.Conclusion:In FE patients, the diagnosis of mania may be overlooked, as they present with more psychotic symptoms than ME patients. The prodromal phase is characterised by high levels of stress, suicide attempts, anxiety disorders and alcohol or substance abuse. Data suggest to consider these prodromes as harmful consequences of temperamental predispositions to bipolar disorder that may concur to precipitate mania onset. Their occurrence should therefore incite clinicians to screen for the presence of such predispositions, in order to identify patients at risk of FE mania.

Early and Late Onset Bipolar Disorders in Older Adults

2017 ◽  
Vol 41 (S1) ◽  
pp. S211-S211
Author(s):  
N. Smaoui ◽  
L. Zouari ◽  
N. Charfi ◽  
M. Maâlej-Bouali ◽  
N. Zouari ◽  
...  
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Early Onset ◽  
Age Of Onset ◽  
Late Onset ◽  
Age At Onset ◽  
Bipolar Disorders ◽  
Medical Diagnoses ◽  
The Mean ◽  
Bipolar Patients

IntroductionAge of onset of illness may be useful in explaining the heterogeneity among older bipolar patients.ObjectiveTo examine the relationship of age of onset with clinical, demographic and behavioral variables, in older patients with bipolar disorder.MethodsThis was a cross-sectional, descriptive and analytical study, including 24 patients suffering from bipolar disorders, aged 65 years or more and followed-up in outpatient psychiatry unit at Hedi Chaker university hospital in Sfax in Tunisia. We used a standardized questionnaire including socio-demographic, behavioral and clinical data. Age of onset was split at age 40 years into early-onset (< 40 years; n = 12) and late-onset (≥ 40 years; n = 12) groups.ResultsThe mean age for the entire sample was 68.95 years. The mean age of onset was 39.95 years. The majority (60%) of patients were diagnosed with bipolar I. Few meaningful differences emerged between early-onset and late-onset groups, except that tobacco use was significantly higher in the late-onset group (66.6% vs. 16.6%; P = 0.027). No significant differences between the early-onset and late-onset groups were seen on demographic variables, family history and number of medical diagnoses or presence of psychotic features.ConclusionOur study found few meaningful behavioral differences between early versus late age at onset in older adults with bipolar disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Aspects of the psychological consequences of cannabis use

2017 ◽  
Vol 41 (S1) ◽  
pp. S479-S479
Author(s):  
L. Montes Reula ◽  
A. Portilla Fernández ◽  
H. Saiz García
Keyword(s):  
Bipolar Disorder ◽  
Suicide Attempts ◽  
Age At Onset ◽  
Cannabis Use ◽  
Psychological Consequences ◽  
Course Of Illness ◽  
Adult Age ◽  
Affective Symptoms ◽  
Competing Interest ◽  
The Relationship

Cannabis is seen among general population as an “anti-depressive drug”. Many papers have been published in the field of investigation about the relationship between cannabis use and affective disorders. We pretend to find the aspect of the psychological consequences of cannabis use.MethodsUsing Pubmed and PsychInfo, we conducted a narrative review of the literature on cannabis and psychiatric comorbidity using the keywords cannabis, psychosis, mood, depression, mania, bipolar, and anxiety.ResultsThere is substantial evidence of an association between cannabis use and psychosis. A few reports suggest an association with bipolar disorder while the association with depression and anxiety disorders is mixed.ConclusionsThe present review confirms earlier findings of an association between cannabis use and a lower age at onset. Data shows that cannabis use, beginning in the adolescence and with a frequency higher than once a week, correlates with the development in adult age of affective symptoms and/or disorder, mainly in bipolar disorder, with a moderate relation with Depressive spectrum. Even more, some authors hypothesize that cannabis may play a role in the development of the disorder, that to say, affective disorder would not appear in the absence of cannabis use. The current findings suggest that recent cannabis use is associated with a more severe course of illness in the early phase of BD I.Recent cannabis use was also associated with more lifetime suicide attempts.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Bipolar disorder and co-occurring cannabis use disorders

2017 ◽  
Vol 41 (S1) ◽  
pp. S466-S466
Author(s):  
S. Ben Mustapha ◽  
W. Homri ◽  
L. Jouini ◽  
R. Labbane
Keyword(s):  
Bipolar Disorder ◽  
Suicide Attempts ◽  
Term Treatment ◽  
Cannabis Use ◽  
Family Dynamic ◽  
Long Term Treatment ◽  
Cannabis Use Disorders ◽  
Competing Interest ◽  
Bipolar Patients ◽  
Psychotic Features

AimsAssess the prevalence of cannabis use disorders (CUD) in patients with bipolar disorder, describe the demographic and clinical profile socio bipolar patients with comorbid addictive and assess the implications of this comorbidity on prognosis and evolution of bipolar disorder.MethodsA case-control study, 100 euthymic patients treated for bipolar disorder, recruited in the department of psychiatry C of Razi hospital. Two groups were individualized by the presence or not of cannabis use disorders comorbidity. The two groups were compared for sociodemographic, clinical, therapeutic and historical characteristics.ResultsThe prevalence of CUD was 27.53% (n = 19) in our sample. Comparing bipolar patients according to the presence or absence of CUD, we found the following results with patients with CUD comorbidity: younger, mostly male, a disturbed family dynamic, low educational level, poor socio-economic conditions, more time abroad history, more suicide attempts in history, more criminal record, more psychiatric family history, an earlier onset of the disease, a longer duration of undiagnosed bipolar disorder, more personality disorder, more frequent presence of a triggering factor for bipolar disorder, more psychotic features during mood episodes, more need of antipsychotic long-term treatment.ConclusionsThe frequency of CUD in BD is higher than the prevalence in the general population and CUD is a factor in the evolution and prognosis of bipolar disorder and promotes the development of mood disorders in predisposed patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Bipolar Disorder and Cannabis

2017 ◽  
Vol 41 (S1) ◽  
pp. S118-S119
Author(s):  
G. Jmii ◽  
M. Zghal ◽  
F. Ghali ◽  
M. Mezghenni ◽  
L. Jouini ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Substance Dependence ◽  
Suicide Attempts ◽  
Bipolar Disorders ◽  
Cross Sectional Study ◽  
Cannabis Use ◽  
Type I ◽  
Cross Sectional ◽  
Average Hospital ◽  
Bipolar Patients

IntroductionPeople with bipolar disorder frequently struggle with substance abuse and dependence. Typically, cannabis is the most commonly abused drug in individuals with bipolar disorder. Some investigators have implied that cannabis may actually be mood stabilizing in patients with bipolar disorder. However, the relationships between cannabis use and bipolar disorders are complex and remain incompletely described.ObjectiveThe aim of this study was to identify the characteristics of addiction to cannabis in bipolar patients type I and determine the consequences of cannabis on the expression of bipolar illness and prognosis.MethodsThis is a comparative cross-sectional study which included patients followed in the psychiatry department of the G Razi hospital for bipolar disorder type I and for substance dependence according to DSM IV diagnostic criteria. Hetero-questionnaire on sociodemographic variables, clinical and treatment.ResultsThe average age was 41 years. The average hospital stay was 9.18 days. 33.33% of patients were monitored regularly. Most patients were single and worked as a day labourer. Cannabis was the most consumed substance. Cannabis use was prior to the expression of psychiatric illness in 55% of cases. The average number of hospitalisation in patients with a cannabis addiction was significantly greater than that observed in the non-addicted group. Similarly, the average number of suicide attempts among patients with cannabis addiction was significantly higher than the group without cannabis addiction.ConclusionsAggressive drug abuse treatment immediately after a first psychiatric hospitalisation might decrease rates of recurrence and new cases of cannabis use disorder in the course of bipolar disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Risk and coaggregation of major psychiatric disorders among first-degree relatives of patients with bipolar disorder: a nationwide population-based study

2018 ◽  
Vol 49 (14) ◽  
pp. 2397-2404 ◽  
Author(s):  
Mu-Hong Chen ◽  
Ju-Wei Hsu ◽  
Kei-Lin Huang ◽  
Tung-Ping Su ◽  
Cheng-Ta Li ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Psychiatric Disorders ◽  
Population Based ◽  
Autism Spectrum ◽  
The Public ◽  
First Degree Relatives ◽  
Relative Risks ◽  
Dependent Relationship ◽  
Increased Risk ◽  
Bipolar Patients

AbstractBackgroundBipolar disorder is a highly heritable mental illness that transmits intergeneratively. Previous studies supported that first-degree relatives (FDRs), such as parents, offspring, and siblings, of patients with bipolar disorder, had a higher risk of bipolar disorder. However, whether FDRs of bipolar patients have an increased risk of schizophrenia, major depressive disorder (MDD), autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD) remains unclear.MethodsAmong the entire population in Taiwan, 87 639 patients with bipolar disorder and 188 290 FDRs of patients with bipolar disorder were identified in our study. The relative risks (RRs) of major psychiatric disorders were assessed among FDRs of patients with bipolar disorder.ResultsFDRs of patients with bipolar disorder were more likely to have a higher risk of major psychiatric disorders, including bipolar disorder (RR 6.12, 95% confidence interval (CI) 5.95–6.30), MDD (RR 2.89, 95% CI 2.82–2.96), schizophrenia (RR 2.64, 95% CI 2.55–2.73), ADHD (RR 2.21, 95% CI 2.13–2.30), and ASD (RR 2.10, 95% CI 1.92–2.29), than the total population did. These increased risks for major psychiatric disorders were consistent across different familial kinships, such as parents, offspring, siblings, and twins. A dose-dependent relationship was also found between risk of each major psychiatric disorder and numbers of bipolar patients.ConclusionsOur study was the first study to support the familial coaggregation of bipolar disorder with other major psychiatric disorders, including schizophrenia, MDD, ADHD, and ASD, in a Taiwanese (non-Caucasian) population. Given the elevated risks of major psychiatric disorders, the public health government should pay more attention to the mental health of FDRs of patients with bipolar disorder.

scholarly journals Age at onset, course of illness and response to psychotherapy in bipolar disorder: results from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD)

2014 ◽  
Vol 44 (16) ◽  
pp. 3455-3467 ◽  
Author(s):  
A. Peters ◽  
L. G. Sylvia ◽  
P. V. da Silva Magalhães ◽  
D. J. Miklowitz ◽  
E. Frank ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Collaborative Care ◽  
Bipolar Depression ◽  
Age At Onset ◽  
Number Needed To Treat ◽  
Systematic Treatment ◽  
Illness Duration ◽  
Bipolar Patients ◽  
Depressive Episodes ◽  
Intensive Psychotherapy

Background.The course of bipolar disorder progressively worsens in some patients. Although responses to pharmacotherapy appear to diminish with greater chronicity, less is known about whether patients' prior courses of illness are related to responses to psychotherapy.Method.Embedded in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) was a randomized controlled trial of psychotherapy for bipolar depression comparing the efficacy of intensive psychotherapy with collaborative care (a three-session psycho-educational intervention). We assessed whether the number of previous mood episodes, age of illness onset, and illness duration predicted or moderated the likelihood of recovery and time until recovery from a depressive episode in patients in the two treatments.Results.Independently of treatment condition, participants with one to nine prior depressive episodes were more likely to recover and had faster time to recovery than those with 20 or more prior depressive episodes. Participants with fewer than 20 prior manic episodes had faster time to recovery than those with 20 or more episodes. Longer illness duration predicted a longer time to recovery. Participants were more likely to recover in intensive psychotherapy than collaborative care if they had 10–20 prior episodes of depression [number needed to treat (NNT) = 2.0], but equally likely to respond to psychotherapy and collaborative care if they had one to nine (NNT = 32.0) or >20 (NNT = 9.0) depressive episodes.Conclusions.Number of previous mood episodes and illness duration are associated with the likelihood and speed of recovery among bipolar patients receiving psychosocial treatments for depression.

Quality of life in bipolar disorders compared to schizophrenia

2011 ◽  
Vol 26 (S2) ◽  
pp. 231-231
Author(s):  
L. Zouari ◽  
I. Abida ◽  
M. Walha ◽  
J. Masmoudi ◽  
J. Ben Thabet ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bipolar Disorder ◽  
Short Form ◽  
Age At Onset ◽  
Bipolar Disorders ◽  
Subscale Score ◽  
Sf 36 ◽  
Schizophrenic Patients ◽  
Bipolar Patients

IntroductionThe classic opinion of a favorable prognosis of bipolar disorders, compared to schizophrenia, is refuted by modern conceptions.ObjectivesThe aim of this study was to assess the quality of life (QOL) in bipolar patients compared to schizophrenic patients’, and to identify clinical and sociodemographic variables statistically associated to a poor QOL in bipolar disorder patients.MethodsOne hundred and twenty outpatients, 50 with bipolar disorder and 70 with schizophrenia, according to DSM-IV-TR criteria, were included in the study. The QOL has been assessed, in all patients, using the «36 item Short-Form Health Survey» (SF-36).ResultsThirty-six percent of the bipolar patients had a poor QOL, versus 37% among the schizophrenic patients. The bipolar patients had the score of the standardized vitality subscale significantly lower than schizophrenic patients’ (p = 0.036); the latter had the standardized general health subscale score significantly lower (p = 0.03). There were no other statistically significant differences. The multivariate analyses showed three variables significantly correlated to a poor QOL in bipolar patients: age at the time of the study ≥ 40 years (p = 0.01), professional irregularity or inactivity (p = 0.005), age at onset ≥ 25 years (p = 0.004).ConclusionOur survey of the QOL in bipolar patients showed that it did not differ globally from the schizophrenic patients’, with the SF-36 scale. Results reported in the literature are not in agreement. Further longitudinal studies on several months, with other assessments, would permit to verify the validity of our results.

scholarly journals Is asthma associated with COVID-19 infection? A UK Biobank analysis

2021 ◽  
pp. 00309-2021
Author(s):  
Caroline J. Lodge ◽  
Alice Doherty ◽  
Dinh Bui ◽  
Raisa Cassim ◽  
Adrian J. Lowe ◽  
...  
Keyword(s):  
Lung Function ◽  
Early Onset ◽  
Age At Onset ◽  
Forced Expiratory Volume ◽  
Normal Weight ◽  
Asthma Medication ◽  
Positive Test ◽  
Uk Biobank ◽  
Increased Risk ◽  
Health Related

BackgroundThe relationship between asthma and COVID-19 risk is not clear and may be influenced by level of airway obstruction, asthma medication, and known COVID risk factors. We aimed to investigate COVID-19 risk in people with asthma.MethodsWe used UK Biobank data from all participants tested for SARS-CoV-2 (n=107 412 (17 979 test positive)). Baseline questions at baseline defined ever asthma and asthma medications. Baseline Forced Expiratory Volume in the first second (FEV1) was categorized into quartiles. Logistic regression modelled relationships between asthma, and asthma categories (age at onset, medications, FEV1 quartiles), and risk of SARS-CoV-2 positive test. We investigated modification by sex, ethnic group, smoking, and BMI.ResultsThere was a reduced risk of a positive test associated with with early-onset asthma (<13 years), (OR 0.91(95% CI 0.84, 0.99). This was found for early-onset asthmatics in males (OR 0·87 [95% CI: 0·78, 0·98]), non-smokers (0·87 [0·78, 0·98]), overweight/obese (0.85 [0.77, 0.93]), and non-Black participants (0·90 [0·82, 0.98]). There was increased risk amongst early onset asthmatics in the highest compared to lowest quartile of lung function (1.44 [1.05, 1.72]).ConclusionAmongst males, non-smokers, overweight/obese, and non-Black participants, having early-onset asthma was associated with lower risk of a SARS-CoV-2 positive test. We found no evidence of a protective effect from asthma medication. Early-onset asthmatics of normal weight and with better lung function may have lifestyle differences placing them at higher risk. Further research is needed to elucidate the contribution of asthma pathophysiology and different health-related behaviour, across population groups, to the observed risks.

Impulsivity predicts illness severity in long-term course of bipolar disorder: A prospective approach

2018 ◽  
Vol 52 (9) ◽  
pp. 876-886 ◽  
Author(s):  
Jonas Rote ◽  
Alice-Mai-Ly Dingelstadt ◽  
Annette Aigner ◽  
Michael Bauer ◽  
Jana Fiebig ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Linear Regression Analysis ◽  
Age At Onset ◽  
Illness Severity ◽  
Observation Time ◽  
Barratt Impulsiveness Scale ◽  
Trait Impulsivity ◽  
Morbidity Index ◽  
Bipolar Patients ◽  
The Impact

Background: Bipolar disorder is a common, severe and chronic mental illness. Despite this, predictors of illness severity remain poorly understood. Impulsivity is reported to be associated with bipolar disorder and aggravating comorbidities. This study therefore sought to examine the predictive value of impulsivity for determining illness severity in euthymic bipolar disorder patients. Methods: Baseline trait impulsivity of 120 bipolar euthymic patients (81 bipolar disorder I [68%], 80 female [67%]) and 51 healthy controls was assessed using Barratt Impulsiveness Scale 11. The impact of impulsivity on illness severity (measured with morbidity index) was prospectively tested in 97 patients with sufficient follow-up data (average observation time: 54.4 weeks), using linear regression analysis. Results: Barratt Impulsiveness Scale 11 total (β = 0.01; p < 0.01) and in particular Barratt Impulsiveness Scale 11 attentional subscale scores (β = 0.04; p < 0.001) predicted illness severity in bipolar disorder, while controlling for other clinical variables. Only age at onset persisted as an additional, but less influential predictor. Barratt Impulsiveness Scale 11 total scores and Barratt Impulsiveness Scale 11 attentional subscale scores were significantly higher in euthymic patients compared to controls. This was not observed for the motor or non-planning subscale scores. Limitations: The average year-long observation time might not be long enough to account for the chronic course of bipolar disorder. Conclusion: Trait impulsivity and particularly attentional impulsivity in euthymic bipolar patients can be strong predictors of illness severity in bipolar disorder. Future studies should explore impulsivity as a risk assessment for morbidity and as a therapeutic target in bipolar disorder patients.

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